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Abstract

Albuminuria is an early, non-invasive marker of kidney injury, and an independent, potentially modifiable, risk factor for cardiovascular disease. Between 1992-96, 1764 community-dwelling men and women 31-98 (mean 71) years old were assessed for albuminuria using spot urine albumin/creatinine ratio (ACR). Median (interquartile range) ACR was 12 (7-20) mg/g. ACR was repeated in 1997-99 (n=926; ACR 12 [7-20]), 1999-2002 (n=977; ACR 16 [9-32]) and 2003-05 (n=755; ACR 11 [6-20]) (Figure). In analyses limited to 977 participants with ACR measured at 1992-96 and 1999-2002 visits, mean 6.6 (range 4.5-9.5) years later, median change in ACR was 4 (-1-17) mg/g; ACR doubled or greater in 36%, halved or less in 10%, and was unchanged in 54%. Table shows change in ACR by baseline characteristics. Using logistic regression, only sex was associated with doubling of ACR (vs. less than doubling); OR 1.42 (95% CI 1.08-1.87, p=0.01) for women; age, blood pressure, and diabetes were not; none of these were associated with halving of ACR. Further studies of predictors of albuminuria may inform future interventions to modify albuminuria and mitigate kidney and cardiovascular risk.